What Is Couples Therapy?

Here’s what you should know before starting couples therapy.

What’s a Couples Therapy Session Like?

Therapy sessions are typically catered to fit each couple’s needs and goals. The sessions might differ in style and structure from couple to couple, depending on the couple’s preferences, the issues being addressed, the expertise and values of the therapist, and other factors.

Therapy sessions commonly take place once a week for about an hour and may involve some homework, according to the research in Family Process. They can be conducted virtually or in-person. The therapy may continue for just a few sessions or go on for years, but most approaches aim for a 3- to 12-month course of treatment.

A hallmark practice in couples therapy is prompting each partner to openly discuss their perspective on their relationship. “Each person has the opportunity to share what’s on their mind, whether it’s the pain points in the relationship, issues that need resolution, or a topic they don’t feel comfortable discussing unless a therapist is present,” says Bronstein.

When the couples communicate, the therapist acts as a mediator and doesn’t take sides, according to the University of Rochester Medical Center. The role of the therapist is to guide both parties, so they can talk about and understand each other’s feelings and learn important relationship skills in a safe environment.

In Carroll’s practice, the skills she aims to help her clients learn depend on the needs of each couple. They may include:

• How to give and accept appreciation, even when you’re upset
• How to talk about a complaint
• How to listen to a complaint without getting defensive
• How to build and nurture a relationship, even when you don’t feel like it

How to Find a Couples Therapist

According to the University of Rochester Medical Center, couples who are looking for a therapist should seek out a licensed mental health professional who specializes in couples therapy, such as the following:

• Licensed clinical social workers (LCSW)
• Licensed marriage and family therapists (LMFT)
• Clinical mental health counselors (CMHC)
• Psychiatrists (MD, DO)
• Psychologists (PhD)

Carroll says it might also be helpful to check out a prospective therapist’s web page. “Listen to any podcasts or interviews they do and see if you can find out what their beliefs are and how they align with yours,” she suggests.

Both the American Association for Marriage and Family Therapy and American Psychological Association provide directories for locating qualified therapists. Asking friends or trusted acquaintances for recommendations may also be an effective way to find a therapist, Bronstein adds.

How To Prepare for a Couples Therapy Session

Before starting couples therapy, it’s a good idea to set goals for how you’d like to achieve a more peaceful, productive relationship, says Bronstein. Planning out what you want to talk about could also be helpful. “I always recommend making bullet points of things you want to discuss in the session,” she says.

You may be given homework assignments to complete between sessions, but sometimes this depends on the couple’s preferences, notes Carroll. In some cases, for example, one person may welcome homework, while the other is opposed to taking on any obligations outside of therapy.

“If they are both eager, I give them homework. If there’s some kind of resistance with one, I give them something very small every day, such as make one acknowledgement of something you appreciate about the other person,” Carroll says.

Who Shouldn’t Try Couples Therapy?

Bronstein says some couples may not benefit as much as others from couples therapy, including those who are experiencing any of what she calls the “three As,” which are:

Sometimes in these situations, couples therapy could do more harm than good, she says. “For example, a couple who is experiencing domestic violence, if they go to therapy, it could exacerbate the problem, and the victim could be in more danger if the abuser gets angered because of therapy,” Bronstein explains.

She recommends individual therapy first for people struggling with addiction, affairs, or abuse, so the person can heal or recover before working on their relationship with someone else, or to work with a professional to form a plan to leave an unsafe relationship if needed.

That said, some practices do offer specialized services for couples facing these types of situations.

Carroll adds that partners who don’t have the right motivations for trying couples therapy might not be good candidates for it. “What many people do is they come in with an agenda that they are going to show their partner the error of their ways, and they’re not willing to put that aside, and it just doesn’t work,” she explains. “You’re not going to convince somebody else to be different.”